Durie B G, Salmon S E, Moon T E
Blood. 1980 Mar;55(3):364-72.
One-hundred fifty patients with multiple (plasma cell) myeloma had pretreatment tumor mass staging, and 79 also had measurement of the pretreatment labeling index (LI%). There were clear differences in survival by pretreatment stage of disease. The pretreatment LI% of bone marrow plasma cells was an independent prognostic factor both in single factor and multivariate regression analyses, including myeloma stage (p less than 0.02). Other important prognostic factors (multivariate) included performance status, serum creatinine, presence of Bence Jones protein, age, and kappa/lambda subtype. A LI% of less than 1% was associated with long survival in each patient group. Patients with benign gammopathy had excellent survival and very low labeling indices. A pretreatment LI% of greater than 3% in high cell mass patients with a high total number of DNA synthesizing cells (S) conferred a very poor prognosis (p = 0.002). This subgroup of patients with high S values also had a high incidence of central nervous system relapse (27%), Bence Jones proteinuria, and elevated serum uric acid levels. We conclude that the pretreatment labeling index provides helpful prognostic information in addition to tumor mass staging.
150例多发性（浆细胞）骨髓瘤患者进行了治疗前肿瘤肿块分期，79例还测定了治疗前标记指数（LI%）。疾病治疗前阶段的生存率存在明显差异。骨髓浆细胞的治疗前LI%在单因素和多因素回归分析中都是独立的预后因素，包括骨髓瘤分期（p<0.02）。其他重要的预后因素（多因素）包括体能状态、血清肌酐、本周氏蛋白的存在、年龄和κ/λ亚型。LI%低于1%与每个患者组的长期生存相关。良性丙种球蛋白病患者生存率极佳，标记指数极低。在DNA合成细胞总数（S）高的高细胞肿块患者中，治疗前LI%大于3%预后极差（p = 0.002）。这个S值高的患者亚组中枢神经系统复发率也很高（27%），伴有本周氏蛋白尿和血清尿酸水平升高。我们得出结论，治疗前标记指数除了提供肿瘤肿块分期信息外，还能提供有用的预后信息。
